Breast Reconstruction Surgery in South Africa | Dr Deon Weyers
Breast reconstruction rebuilds the shape of the breast after mastectomy, lumpectomy, injury or a difference present from birth. It is planned around your treatment, your body and your own timing.
Reconstruction is part of recovering from breast surgery, not an afterthought to it. Dr Deon Weyers, a board-certified plastic and reconstructive surgeon at Life Fourways Hospital in Johannesburg, works alongside your breast surgeon and oncology team so that the reconstructive plan fits your cancer treatment rather than competing with it.
Some women choose reconstruction at the time of mastectomy, some months or years later, and some decide against it. Each of these is a legitimate choice. The aim of a consultation is to explain the options clearly so that the decision is yours.
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Breast Reconstruction for Patients Across South Africa
Patients come to the Fourways practice from across South Africa for breast reconstruction, often referred by their breast surgeon or oncologist. Reconstruction is an active part of the practice, alongside cosmetic breast surgery.
Breast reconstruction recreates a breast shape after tissue has been removed or altered. The most common reason is breast cancer surgery, whether a full mastectomy or a lumpectomy that has changed the shape of the breast. It is also used after a traumatic injury to the breast and for shape irregularities that are present from birth.
- After mastectomy
- After lumpectomy
- Immediate or delayed
- Implant or own tissue
- Hospital-based surgery
Reconstruction is usually done in stages. The first operation creates the new breast mound, and later, smaller procedures may refine the shape or improve symmetry with the other breast. How many stages you need depends on the technique, any radiotherapy, and how your tissues heal.
Because Dr Weyers practises both reconstructive and cosmetic breast surgery, the planning draws on techniques from both, including implant surgery, breast reduction and fat transfer, which can be used to refine contour.
Two Broad Ways to Rebuild a Breast
Implant reconstruction uses a silicone or saline implant, placed under or above the chest muscle, to create the breast shape. It avoids a second surgical site on the body and is often staged, particularly where the skin needs to be prepared first.
Flap reconstruction uses a section of your own tissue, moved from another part of the body, to form the new breast. It avoids an implant but involves a donor site with its own healing. Which approach suits you depends on your body, your cancer treatment and your preferences, and is discussed in detail at consultation.
Reconstruction is a choice, not an obligation. Deciding to wait, or deciding not to have it at all, is just as valid as having it at the time of mastectomy.
Immediate vs Delayed Breast Reconstruction
Immediate Reconstruction
Reconstruction begins in the same operation as the mastectomy, planned jointly with your breast surgeon.
You wake up with a breast shape already started. It suits some patients well, but depends on whether radiotherapy or other treatment is expected afterwards.
Delayed Reconstruction
Reconstruction is done as a separate operation, a month or even years after the cancer surgery.
It allows cancer treatment to finish first and gives you time to decide. It is available long after mastectomy; there is no deadline.
| Aspect | Immediate | Delayed |
|---|---|---|
| When it happens | At the same time as the mastectomy | Weeks, months or years later |
| Planned with | Your breast surgeon and oncology team, before the cancer operation | Your oncology team, once treatment allows |
| Number of operations | Fewer separate admissions in some cases | A separate admission for each stage |
| Radiotherapy | Planning must take expected radiotherapy into account | Often done after radiotherapy has finished |
| Time to decide | The decision is made before cancer surgery | More time to consider options after treatment |
How Breast Reconstruction Is Planned and Performed
Reconstruction is performed in hospital at Life Fourways Hospital. Dr Deon Weyers performs the reconstructive surgery personally and keeps your oncology team informed throughout.
Referral and records
Your breast surgeon or oncologist shares the details of your diagnosis and treatment plan, or you bring these records to the first appointment.
Reconstructive consultation
A discussion of immediate versus delayed timing, implant versus own-tissue options, the likely number of stages and what recovery involves for each.
Medical aid pre-authorisation
For reconstruction after cancer surgery, the practice prepares the motivation your medical aid needs before surgery is scheduled.
Surgery
Performed under anaesthesia in theatre. Drains may be placed at the incisions to remove excess fluid, and a surgical support bra is fitted.
Hospital stay and follow-up
You may stay in hospital for up to a week, depending on the technique. Follow-up visits monitor healing and plan any later refinement stages.
Who May Consider Breast Reconstruction
Reconstruction may be appropriate if you have had, or are about to have, surgery that removes or changes breast tissue, or if a difference in breast shape has been present since development.
- After mastectomy – Removal of the whole breast as part of cancer treatment or risk reduction
- After lumpectomy – Breast-conserving surgery that has left a noticeable change in shape or size
- Other breast illness – Tissue removed for conditions other than cancer
- Traumatic injury – Breast tissue damaged or lost through injury
- Differences present from birth – Shape irregularities that developed as the breasts grew
Suitability also depends on your general health, smoking status and the stage of your cancer treatment. These are assessed in person, together with input from your oncology team where relevant.
Preparing for Your Reconstruction Consultation
A first consultation covers a lot of ground. These steps help you get the most from it.
- Bring your treatment records.including the surgery you have had or are scheduled for, and whether radiotherapy or chemotherapy is planned
- Note your own priorities.such as avoiding an implant, limiting the number of operations or timing surgery around work and family
- Check your medical aid plan.so the practice can begin the pre-authorisation process early
- Arrange support at home.for the first weeks after surgery, when lifting and reaching are limited
What Breast Reconstruction Costs
The practice publishes a typical range of R80,000 to R100,000 for breast reconstruction procedures, covering the surgeon, hospital and anaesthetist. The figure for your reconstruction depends on the technique, the number of stages and the length of your hospital stay, and is confirmed in a written quote after consultation. See breast reconstruction prices for the published detail.
Reconstruction after cancer surgery is different from cosmetic breast surgery. South African medical aids often contribute to reconstruction after mastectomy, but cover depends on your scheme and plan and is decided by the scheme on receipt of a motivation. The practice supplies the documentation needed for that application.
Reconstruction for other reasons, such as a congenital difference or injury, may also be considered by a medical aid, but this is assessed case by case. Any amount not covered is set out in writing before surgery.
Misconceptions About Breast Reconstruction
Many women are given little information about reconstruction at the time of diagnosis. These points come up often.
Risks and Possible Complications
Recognised Risks of Breast Reconstruction
General: bleeding, a collection of blood or fluid, infection, slow wound healing and the risks of anaesthesia.
Implant-related: firmness from capsule tightening, implant exposure or loss, and future implant replacement.
Flap-related: partial or complete loss of the moved tissue, and healing problems or weakness at the donor site.
Overall result: asymmetry, reduced sensation and the possibility of further operations to refine the outcome.
Lowering the Risk
- Stop smoking – well before surgery; it reduces blood supply to healing tissue and flaps.
- Share your full treatment plan – so radiotherapy and chemotherapy timing can be taken into account.
- Follow drain and bra instructions – exactly as given at discharge.
- Keep every review – so problems are picked up early.
Phone the practice without delay if the reconstructed breast becomes hot, red, increasingly swollen or changes colour, or if you develop a fever. The practice provides out-of-hours contact details after surgery.
Medical disclaimer. This page is general information and does not replace a face-to-face consultation. Surgical decisions require an in-person assessment, a full consent discussion and the individual medical advice of your surgeon and anaesthetist.
Breast Reconstruction South Africa: Frequently Asked Questions
Does medical aid cover breast reconstruction after mastectomy?
Many South African medical aids contribute to reconstruction after cancer surgery, but the level of cover depends on your scheme and plan. The practice prepares the motivation and documents the scheme requires.
Can reconstruction be done at the same time as my mastectomy?
Often, yes. Immediate reconstruction is planned with your breast surgeon. Whether it suits you depends on your cancer treatment, particularly whether radiotherapy is expected.
Is it too late if my mastectomy was years ago?
No. Delayed reconstruction can be done long after the original surgery, once your general health and treatment allow.
Will I need more than one operation?
Usually. The first operation creates the breast shape, and later procedures may refine the shape or improve symmetry. The likely number of stages is discussed at consultation.
How long will I be in hospital?
It depends on the technique. Some patients go home after a short stay, while others stay for up to a week to make sure healing is on track.
How long is the recovery?
Swelling and bruising usually begin to settle over two to three weeks, normal routines are often resumed around eight weeks, and the final shape can take up to six months to show.
Can reconstruction be done with my own tissue instead of an implant?
Own-tissue (flap) reconstruction is one of the options. Whether it suits you depends on your body and treatment, and is assessed in person.
Where is the surgery done?
All reconstructive surgery is done at Life Fourways Hospital in Johannesburg. Patients from other provinces travel to the practice, which has no other branches.
Speak to Dr Deon Weyers About Breast Reconstruction
Dr Deon Weyers is a board-certified plastic and reconstructive surgeon, registered with the Health Professions Council of South Africa and a member of APRASSA. He sees reconstruction patients from across South Africa at the practice’s single location at Life Fourways Hospital and works alongside your oncology team.
Call 011 875 1694
Office hours: Monday to Thursday 08:00 – 17:00, Friday 08:00 – 14:00 · send a message
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